Coaching is emerging as a form of facilitation in health professions education. Most studies focus on one-on-one coaching rather than team coaching. We assessed the experiences of interprofessional teams coached to simultaneously improve primary care residency training and interprofessional practice.
This three-year exploratory mixed methods study included transformational assistance from 9 interprofessional coaches, one assigned to each of 9 interprofessional primary care teams that included family medicine, internal medicine, pediatrics, nursing, pharmacy and behavioral health. Coaches interacted with teams during 2 in-person training sessions, an in-person site visit, and then as requested by their teams. Surveys administered at 1?year and end study assessed the coaching relationship and process.
The majority of participants (82% at end of Year 1 and 76.6% at end study) agreed or strongly agreed that their coach developed a positive working relationship with their team. Participants indicated coachesmong clinicians and staff as well as with interprofessional learners rotating through their outpatient clinics.Guided by a convoy model of social relations, this study investigates the relationships between grandparenting status, social relations, and mortality among community-dwelling grandparents age 65 and older who are caring for their grandchildren. The data were drawn from the 2008 and 2016 waves of the Health and Retirement Study (N = 564). Latent class analysis was used to identify the social network structure based on six indicators of interpersonal relationships and activities. A series of hierarchical Weibull hazard models estimated the associations between grandparent caregiving, social relations, and mortality risk. Results of survival analyses indicate that co-parenting and custodial grandparents had higher all-cause mortality risk than grandparents who babysat occasionally; however, for custodial grandparents, the association was not significant once social relation variables were added to the model. This study suggests that community-based support may be beneficial to older grandparents and improved relationship quality is integral to the well-being of older adults.Sexual and gender minority (SGM) individuals are at increased risk for experiencing sexual violence. Bystander intervention training programs are a first-line prevention recommendation for reducing sexual and dating violence on college campuses. Little is known regarding the extent to which SGM individuals are represented in the content of bystander intervention programs or are included in studies examining the effectiveness of bystander intervention programs. The present critical review aimed to fill this gap in knowledge. Twenty-eight empirical peer-reviewed evaluations of bystander intervention programs aimed at reducing dating violence or sexual assault on college campuses were examined. Three studies (10.7%) described including content representing SGM individuals in the program. Personal communication with study authors indicated that-although not mentioned in the publication-many programs describe rates of violence among SGM students. When describing the study sample, six studies (21.4%) indicated that transgender, nonbinary, or students classified as "other" were included in the research. Approximately two thirds of studies (67.9%) did not describe participants' sexual orientation. No studies reported outcomes specifically among SGM individuals, and two (7.1%) mentioned a lack of SGM inclusion as a study limitation. Work is needed to better represent SGM individuals in the content of bystander intervention programs and ensure adequate representation of SGM individuals in studies examining the effectiveness of bystander intervention programs.While palliative home care is advocated for people with dementia, evidence of its effectiveness is lacking.
To evaluate the effects of palliative home care on quality and costs of end-of-life care for older people with dementia.
Decedent cohort study using linked nationwide administrative databases and propensity score matching.
All home-dwelling older people who died with dementia between 2010 and 2015 in Belgium (?=?23,670).
Receiving palliative home care support for the first time between 360 and 15?days before death.
Five thousand six hundred and thirty-seven (23.8%) received palliative home care support in the last 2?years of life, of whom 2918 received it for the first time between 360 and 15?days before death. Two thousand eight hundred and thirty-nine people who received support were matched to 2839 people who received usual care. After matching, those using palliative home care support, in the last 14?days of life, had lower risk of hospital admission (17.5% vs 50.5%; relative risk (RR)?=?0.21), undergoing diagnostic testing (17.0% vs 53.6%; RR?=?0.20) and receiving inappropriate medications, but were more likely to die at home (75.7% vs 32.6%; RR?=?6.45) and to have primary care professional contacts (mean 11.7 vs mean 5.2), compared with those who did not. Further, they had lower mean total costs of care in the last 30?days of life (incremental cost-?2129).
Palliative home care use by home-dwelling older people with dementia is associated with improved quality and reduced costs of end-of-life care. https://www.selleckchem.com/products/epacadostat-incb024360.html Access remains low and should be increased.
Palliative home care use by home-dwelling older people with dementia is associated with improved quality and reduced costs of end-of-life care. Access remains low and should be increased.To assess primary care contributions to behavioral health in addressing unmet mental healthcare needs due to the COVID-19 pandemic.
Secondary data analysis of 2016 to 2018 Medical Expenditure Panel Survey of non-institutionalized US adults. We performed bivariate analysis to estimate the number and percentage of office-based visits and prescription medications for depression and anxiety disorders, any mental illness (AMI), and severe mental illness (AMI) by physician specialty (primary care, psychiatry, and subspecialty) and medical complexity. We ran summary statistics to compare the differences in sociodemographic factors between patients with AMI by seeing a primary care physician versus those seeing a psychiatrist. Binary logistic regression models were estimated to examine the likelihood of having a primary care visit versus psychiatrist visit for a given mental illness.
There were 394 023 office-based visits in the analysis sample. AMI patients seeing primary care physician were thrice as likely to report 1 or more chronic conditions compared to those seeing psychiatrist.